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Research Progress of Fast Track Surgery in Laparoscopic Radical Gastrectomy for Gastric Cancer

Chinese Journal of Minimally Invasive Surgery.2017;17(5):471-474. doi:10.3969/j.issn.1009-6604.2017.05.022

Fast track surgery(FTS) can reduce the patients' surgery stress response, maintain the physiological state of the patients, decrease the risk of postoperative complications and then accelerate recovery after surgery.At present, the FTS protocol in laparoscopic radical gastrectomy for gastric cancer is still in a preliminary stage, and its safety and validity remains to be verified.This systemic and comprehensive review focused on the concept of rapid rehabilitation surgery, the program of perioperative treatment, the economic benefit and its future outlook.

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Advances in Prevention of Transurethral Resection of Prostate Syndrome in Four Stage Surgical Complications of Hysteroscopy

Jing SUN

Chinese Journal of Minimally Invasive Surgery.2017;17(5):466-470. doi:10.3969/j.issn.1009-6604.2017.05.021

In hysteroscopic surgery, transurethral resection of prostate (TURP) syndrome is due to the pressure and distention of uterine distention medium.A large number of uterine distention fluid absorption causes dilution hyponatremia and hypervolemia and a series of clinical symptoms.When not timely diagnosed and treated, it may become fatal.The four stage hysteroscopic surgery is the highest difficult and the most prone to TURP syndrome.This paper reviewed current situation of hysteroscopy with TURP syndrome in recent years and explored the risk factors of TURP syndrome during hysteroscopy, for a more targeted prevention of TURP syndrome.

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Application of Tracheal Intubation Guided by Fiberoptic Bronchoscopy in Children Snoring Disease Operation

Jianwei ZHANG ; Dongliang TANG ; Jin XU

Chinese Journal of Minimally Invasive Surgery.2017;17(8):714-716. doi:10.3969/j.issn.1009-6604.2017.08.012

Objective To explore the value of tracheal intubation guided by fiberoptic bronchoscopy in children snoring disease operation.Methods A total of 50 patients underwent tracheal intubation guided by fiberoptic bronchoscope or laryngoscope from August 2015 to June 2016.There were 25 cases of fiberoptic bronchoscopy assigned into group A, 25 cases of laryngoscopy into group B.The intubation time, success rate and adverse reactions of the two groups were compared and analyzed.Results All the intubation in group A succeed at the first time.The intubation time was (20.1±4.3) s and the position was right.There was no need for replacement during the operation.Three cases in group B succeed at the second time because the tonsil was too big to expose the pharynx.The intubation got out of the pharynx in 3 cases in group B and were adjusted to the right position.The intubation time was (50.7±6.9) s and the success rate at the first time was 76% (19/25).Groups A behaved better than group B in aspects of the success rate of signal intubation and intubation time (Fisher''s Exact Test, P=0.022;t=-18.725, P=0.000).There were no adverse reactions in group A, such as pharyngorrhagia, odontoseisis or loss of tooth, laryngospasm and so on.There were 3 cases of hemorrhage from throat after intubation, 3 cases of loss of tooth in different degrees and 1 case of laryngospasm at second intubation time in group B.There was no significant difference in adverse reactions between the two groups (P>0.05).ConclusionFiberoptic bronchoscopy can be used for children snoring disease with good safety as well as rare adverse reactions.

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On Diagnosis and Treatment Value of Laparoscopy for Unexplained Chronic Abdominal Pain

Qi YANG ; Chengyu LUO

Chinese Journal of Minimally Invasive Surgery.2017;17(8):695-697. doi:10.3969/j.issn.1009-6604.2017.08.006

Objective To investigate the value of laparoscopy in the diagnosis and treatment of unexplained chronic abdominal pain.Methods From January 2014 to February 2016, clinical data of 56 unexplained chronic abdominal pain undergoing laparoscopic surgery were analyzed retrospectively.Laparoscopic exploration was performed firstly and then the corresponding abnormalities were diagnosed and dealt with accordingly.Results The disease causes were explicit in 48 cases (85.7%), including 25 cases of abdominal adhesions, 8 cases of chronic appendicitis, 2 cases of small intestinal diverticulum, 2 cases of intestinal tuberculosis, 2 cases of lymphoma, 5 cases of endometriosis, 2 cases of tubal adhesions, 1 case of peritoneal metastasis of gastric cancer after surgery, and 1 case of appendiceal mucinous adenocarcinoma.Surgical treatment was performed in 43 cases, 3 of whom were converted to laparotomy.There were no postoperative complications in the 56 cases.The follow-up rate was 92.9% (52/56), and lost of follow-up was in 4 cases.The follow-up duration was from 3 months to 3 years (median, 19.4 months).There was 1 death case (peritoneal carcinomatosis).There were 35 cases (62.5%) of complete relief of abdominal pain (no recurrence of preoperative abdominal pain symptoms) and 12 cases (21.4%) of pain relief (preoperative pain decreased or interval extended).The total effective rate was 83.9% (47/56).Conclusion Laparoscopy is of high value in the diagnosis and treatment of unexplained chronic abdominal pain.

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Partial Nephrectomy of Renal Tumor with Three-dimensional Laparoscopy: Report of 11 Cases

Chaoguang MA ; Chengzhi YAN

Chinese Journal of Minimally Invasive Surgery.2017;17(8):704-706,713. doi:10.3969/j.issn.1009-6604.2017.08.009

Objective To analyze the effect of partial nephrectomy with three-dimensional laparoscopy for the treatment of renal tumor.Methods From October 2013 to September 2015, 11 patients underwent 3D laparoscopic partial nephrectomy for renal tumor in our hospital.All the cases were given retroperitoneal approach.The renal artery was seperated and blocked, and the renal tumor was exposed and completely resected around the edge.The wound was double layer sutured with Vicryl.Results All the 11 operations were finished smoothly without conversion to open surgery.The operative time was 70-180 min (mean, 100 min), the ischemic time was 14-35 min (mean, 25 min), and the estimated blood loss was 50-300 ml (mean, 90 ml).There were 1 case of intraoperative peritoneal perforation, 2 cases of subcutaneous emphysema, and 1 case of perirenal hematoma.No other operative or postoperative complications occurred.The post-operative hospital stay was 5-10 d (mean, 6 d).Post-operative follow-ups for 3-14 months (mean, 10 months) in 10 cases found no recurrence or metastasis or renal dysfunction.Conclusions Partial nephrectomy of renal tumor with three-dimensional laparoscopy is safe and feasible.The outcome is satisfying and worthy of application.

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History and Current Status of Cholecystolithotomy with Gallbladder Conservation in Overseas

Shaohong GUO

Chinese Journal of Minimally Invasive Surgery.2017;17(8):673-679. doi:10.3969/j.issn.1009-6604.2017.08.001

For answering the question of whether the operation of cholecystolithotomy with gallbladder conservation is popular in overseas, the author made a literature review.It was found that in the past 340 years'' clinical practice in western countries, the research on preservation of gallbladder has been persisted till now.Many methods have been created with certain effects and at the same time some problems.Further studies are needed.

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A Discussion on the TURP Opportunity After Transrectal Prostate Biopsy

Hongyu ZHUANG ; Tao PENG ; Yongguang JIANG

Chinese Journal of Minimally Invasive Surgery.2017;17(9):800-802. doi:10.3969/j.issn.1009-6604.2017.09.011

Objective To discuss the opportunity of transurethral resection of prostate (TURP) after transrectal prostate biopsy.Methods We analyzed 60 cases of benign prostatic hyperplasia(BPH) who underwent TURP after transrectal prostate biopsy from September 2013 to September 2015.All the patients were divided into either group A or group B in chronological order, with 30 cases in each group.There were no significant differences in age, prostate specific antigen (PSA), prostate volume, hemoglobin level, and international prostate symptom score (IPSS) between the two groups.The group A and group B were treated by TURP at 1 week and 4 weeks after transrectal prostate biopsy, respectively.The parameters including operation time, excised prostate weight, intraoperative total blood loss, bladder irrigation time, and IPSS at 3 months after operation were recorded.Results The operation time, intraoperative total blood loss, bladder irrigation time, and IPSS in the group B were significantly lower than those in the group A [(58.3±6.0) min vs.(62.0±3.3) min, t=2.952, P=0.005;(154.1±15.8) ml vs.(167.4±29.5) ml, t=2.181, P=0.035;(19.2±0.8) h vs.(20.6±2.3) h, t=3.034, P=0.004;(18.3±2.5) points vs.(20.3±2.0) points, t=3.419, P=0.001].The excised prostate weight in the group B was significantly higher than that in the group A [(37.1±4.0) g vs.(33.3±7.8) g, t=-2.341, P=0.024].Conclusions TURP performed at 4 weeks after transrectal prostate biopsy can significantly increase the excised prostate weight, reduce intraoperative total blood loss volume, shorten the operation time and postoperative bladder irrigation time, and improve urinary symptoms.In brief, we recommend that TURP be executed at 4 weeks after transrectal prostate biopsy.

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Clinical Effects of Hysteroscopic Resection for Mild-to-moderate Uterine Incision Diverticulum After Cesarean Section

Lihong TANG ; Aihua ZHANG ; Hongjuan ZHANG

Chinese Journal of Minimally Invasive Surgery.2017;17(9):798-799,817. doi:10.3969/j.issn.1009-6604.2017.09.010

Objective To investigate the effects of hysteroscopic resection for mild-to-moderate uterine incision diverticulum after cesarean section.Methods From September 2010 to September 2014, hysteroscopic resection was performed under B-ultrasonography in 102 cases of mild-to-moderate uterine incision diverticulum after cesarean section.Results The operation was completed successfully in all the cases, without surgical complications.Outcome evaluation at 1 year after surgery showed cured in 89 cases (87.3%, complete disappearance of symptoms and recovery of normal menstruation), improved in 7 cases (6.9%, menstrual period shortened by 5-7 d, with or without lower abdominal dull pain and menstrual exacerbation), and ineffective in 6 cases (5.9%, no or slight symptom improvement).Conclusion Hysteroscopic resection is a safe, effective, and minimally invasive method for mild-to-moderate uterine incision diverticulum after cesarean section in patients demanding clinical symptom improvement without desire of fertility.

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Clinical Analysis of 22 Cases of Pediatric Periappendicural Abscess Treated with Laparoscopic Surgery

Yufeng CHEN ; Hualei CUI ; Guibin LI

Chinese Journal of Minimally Invasive Surgery.2017;17(9):787-789. doi:10.3969/j.issn.1009-6604.2017.09.007

Objective To explore the feasibility of laparoscopic surgery in the treatment of pediatric periappendicural abscess.Methods A total of 22 cases of pediatric periappendicural abscess were treated with laparoscopic surgery from April 2013 to May 2016.In the operation, we performed the separation from the side of the abdominal wall and abscess adhesion, and then lifted the abscess for blunt separation into the abscess cavity.After the management of appendix stump, the abdominal cavity was washed and a peritoneal drainage tube was placed.Results Laparoscopic appendectomy was performed successfully in all the cases.No conversion to open laparotomy was needed.The operation time was (65.3±8.2) min, the intraoperative blood loss was (10.5±4.2) ml, and the postoperative hospitalization was (6.5±1.4) days.Follow-ups for 6-24 months (mean, 12 months) in the 22 cases found no complications, such as abdominal abscess, stump fistula, stump appendicitis or adhesive ileus.Conclusion The application of laparoscopic surgery in the treatment of pediatric periappendicural abscess is feasible and safe.

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Minimally Invasive Stealth Lateral Internal Sphincter Release for Chronic Anal Fissure:a Report of 42 Cases

Weiguang Lü ; Qinfeng SUN ; Zhongliang ZHU

Chinese Journal of Minimally Invasive Surgery.2015;(6):536-537,542. doi:10.3969/j.issn.1009-6604.2015.06.015

Objective To investigate the safety and feasibility of minimally invasive stealth lateral release operation in the treatment of chronic anal fissure . Methods Clinical data of 42 patients with chronic anal fissure who underwent minimally invasive stealth lateral release from May 2012 to May 2014 was analyzed retrospectively .We use the homemade fine steel wire to pierce into the sphincter ditch with a distance from the anus of 1 cm, and put the steel wire out above the dentate line .Then the wire was took out from the other edge under the skin through the needle of bobbin .After the needle was fixed by an assistant , the free end of the steel wire was pulled quickly to cut the internal sphincter tissue instantly . Results All the 42 patients were successfully treated and discharged without complications .The recovery time was in 7 -14 d, with an average of 9 d.The healing standards included disappeared symptoms and totally healed wound .All the patients were followed up for 3-6 months, with an average of 4 months.No recurrence was found . Conclusion Minimally invasive stealth lateral release in the treatment of chronic anal fissure is safe and feasible, with many advantages such as simple performance , reliable curative effect, fast recovery time, and less postoperative complications .

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